ssrpk
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A 41- year old man had a violent headache and was found unresponsive. He had been known to be hypertensive for the preceeding 10 years. He was admitted to the hospital for evaluation. Both lower limbs were weak and spastic. The upper limbs were also weak,but the patient could move them slightly. Verbal communication was impossible. Horizontal gaze in either direction was abolished, but the patient could look up and down with both eyes.What might the patient have?
a- One and a half syndrome
b- Internuclear opthalmoplegia
c- Locked-in-state
d- Weber's syndrome
e- Parinaud's syndrome
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| KEROCHI
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Let me try..
A. i've no idea
B. lat. gaze palsy-MLF-MS
C. MY GUESS!!
I know it's not D or E.
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| ssrpk
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hi,
correct answer is c- Locked-in-state
results 4m occlusion of basilar artery b/w branch point of cerebellar arteries (sup. & inf.)
Sx: quadreplegia (bilateral invovement of CS tracts) ,biltarela corticobulbar lesions (all CN's except CNIII) {can communicate by moving their eyes up oir down or by raising their eyelids} ,cold caoric testing results in horizontal deviation of eys towards the stimulus without any corrective phase of nystagmus!
in addition body and face3 sensations are intact, hearing is preserved, and ascending arousal system remains unaffected!
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| mesh
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good one...
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| ureterpolyp
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too hard for me
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| ssrpk
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hey it'; reallty not tht hard!
just realize what is being effected!
as the lesion is effecting the ventral pons therefore corticospinal and corticobulbar tracts are the most susceptible, and as the lesion is involving the pons therefore every motor nerve below the level of CNIII & IV will be effected!......try to work these out!
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